Chorley, South Ribble and Preston whole health economy

Report
Seven Day Services ….
Our Journey …
Chorley, South Ribble and Preston whole health economy
Improving health outcomes across England by providing improvement and change expertise
Christina Lawrenson :
General Manager, Emergency Medicine, Lancashire Teaching Hospital
NHS Foundation Trust.
Jane Kitchen:
Transformation Manager Chorley, South Ribble and Greater Preston
Clinical Commissioning Groups.
Kate Burgess:
Locality Commissioning Manager, Lancashire County Council.
Deborah Howe
Adult Community Services , Lancashire Care Foundation Trust
Improving health outcomes across England by providing improvement and change expertise
Improving health outcomes across England by providing improvement and change expertise
Improving health outcomes across England by providing improvement and change expertise
2. Care Coordinator
1. Streamlining Access
Ability to flex the model
Clinical leadership
More effective use of the contracts
Critical friend to the acute
Removal of multiple handoffs
Coordinator between the acute and the community services
Improve communication and coordination
Ability to test the discharge model as step up/step down and Intensive
Home Support
Test the step up/down business case
Ownership of issues and mitigation
Therapy to Therapy direct referrals
Challenge on ‘medically unfit’ to be discharged decisions
7. Intensive Home Support
7. IHS
Understanding of what service available
1. Streamlining
Access
Trust has been built in the community offer
Care coordinator targeting community matrons
Understanding the capacity and availability
2. Care
Coordinator
More targeted approach to step up
6. CHESS
Perfect Month
6. Care Home Effective Support Service
3.Winter Schemes that offered 7 day cover
Pop up clinic in Preston town centre weekends
GP Visiting Scheme linked to NWAS call outs 7 days
24hrs
Support MAU ward rounds
In-reach into the hospital
NWAS Ambulance Liaison Officer in A&E 7 days
Support the discharge process
Mobilisation of intensive home support
Identification of people on INT case loads
Advance practitioner level driving
operations
5. Culture Change
3. Winter
Planning
5. Culture
Change
4. Weekly
Operational
Meeting &
Relationships
4. Weekly Operational Meeting
Weekly dashboard – to include community services
and LoS
Common understanding of a vision
Different approach to Bed meetings
Changing culture on ‘we need more nursing beds’
mentality
Aligning with the core principles of the urgent care
programme
GPs in A&E at Chorley Weekends and BH’s
LTH Support: Geriatrician, Extended Nutrition Team,
7/7 Therapy, Transfer Team, 7 Day Treatment Rooms
Additional Step Down beds including Intermediate
care when needed
Longridge acceptance of out of area patients
Discharge to assess
Trusting professional judgement
Enhanced social work provision 7 days
Understanding of system wide capacity and demand
Increased provision of Rapid Response
Emergency Medicine Decisions Unit
Consultant ward rounds at weekends in medicine
Discharge Lounge at RPH and CDH
Ownership of the model
Community pharmacy and take home medicine
Relationships across the health economy
Utilising all services such as Domiciliary Rehab
Improving health outcomes across England by providing improvement and change expertise
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……Some of our biggest wins cost us nothing…..
Ethos of Everyone's has a bed and it is in their own
home
Better patient experience
Discharge to assess principle , not assess to
discharge
Direct therapy to therapy referrals
Achievement of the four hour target
Inception of seven day services …
No blame culture
Collective responsibility “its our target”
Action focused weekly operational meetings
Improving health outcomes across England by providing improvement and change expertise
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Keep our patients at the heart of what we do , involve
them in the shaping of our services
Build on the achievements and learning from Perfect
Month
The Urgent Care Transformation program and 7 day
services are interdependent to achieve success
It is a long Journey … but we are all committed to the
same direction utilising opportunities along the way..
Improving health outcomes across England by providing improvement and change expertise
Improving health outcomes across England by providing improvement and change expertise
Improving health outcomes across England by providing improvement and change expertise

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